Photo: David M. Trettin, M.D

David M. Trettin, M.D.
Board-Certified Orthopaedic Surgeon
North Louisiana Orthopaedic & Sports Medicine Clinic
Subspecialty: Certified in Orthopaedic Sports Medicine

KNEE PAIN

One of the most common musculoskeletal complaints that bring people to their doctor is knee pain. In our group practice in Monroe at the North Louisiana Orthopaedic & Sports Medicine Clinic, almost 40% of the new patients that we see complain of knee pain. In fact, the number of knee problems experienced by people of all ages has grown as a result of an increasingly active society.

The knee joint is the largest joint in the body. The upper and lower bones of the knee are separated by two discs (menisci). The upper leg bone (femur) and lower leg bones (tibia and fibula) are connected by ligaments, tendons and muscles. The surfaces of the bones inside the knee joint are covered by articular cartilage which absorb shock and provides a smooth gliding surface for joint movement.

While the knee joint’s main function is to act as a hinge in order to bend and straighten the body, the knee can also twist and rotate. Thus, injuries to the knee and overuse of the knee may hurt both the bone and also the ligaments, tendons and cartilages that help support the knee.

While many jobs, sports and recreational activity, getting older or having a disease such as osteoporosis or osteoarthritis increase the chances of having knee problems, injury is the most common cause of knee problems. Sudden or acute injuries may be caused by a direct blow to the knee from abnormal twisting, bending or falling. Pain, bruising and swelling may be severe and develop within minutes of the injury. The nerves, blood vessels, bursa (fluid sacs) which allow tendons to rub over the bone may be pinched or damaged during the knee injury. The knee or lower leg may feel numb, weak, cold, tingle or look bruised or blue. Swelling can occur sometimes very quickly after knee injuries.

Acute injuries to the knee may include:

  1. Sprain, strain or other injuries to the ligaments or tendons.
  2. Tear in the rubbery cushion to the knee joint (the meniscus), ligament tear such as an anterior cruciate ligament (ACL) or medial collateral ligament (MCL).
  3. Breaks or fractures of the kneecap, lower portion of the femur or upper part of the tibia or fibula.
  4. Severe force to bend the knee or when the knee forcefully hits an object.
  5. Kneecap dislocation. This type of dislocation occurs most frequently in 13-17-year-old girls.

Overuse injuries occur with repetitive activities or prolonged pressure on the knee. Activities such as stair climbing, bicycle riding, jogging or jumping stress the joints and tendons that support the knee and can lead to irritation and inflammation. In children, injuries to the growth plate and overuse injuries to the growth plate (Os-Good Schlatter’s) are fairly common. Other common causes of children’s knee pain include infections, tendinitis and adult-type injuries as well.

Most knee injuries and knee pain can be diagnosed in the office with a thorough history and physical exam. X-rays and occasionally an MRI scan can help confirm the diagnosis. Once the correct diagnosis of the knee pain is made, the treatment plan (medicine, physical therapy, surgery, etc.) can then be discussed with the patient. The orthopaedic surgeons at North Louisiana Orthopaedic & Sports Medicine Clinic are uniquely trained to diagnose and treat correctly knee pain or knee injuries. Please come and see one of our board-certified orthopaedic surgeons about your knee pain.

David M. Trettin, M.D.